Lane, Claire Alice (2012)
Clin.Psy.D. thesis, University of Birmingham.
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Despite many studies of language use in motivational interviewing, the vast majority have based this upon the quantitative coding of practitioner and client linguistic behaviours in order to relate these to client change outcomes. The current study aimed to investigate how clients and practitioners co-constructed the process of change using discourse analysis. Ten MI sessions for alcohol use were analysed in terms of how alcohol was verbally constructed, the functions and effects of rhetorical strategies employed and subject positions. Power and subjectivity were considered alongside these strands of analysis. The findings suggest that clients and therapists constructed alcohol as either a destroyer or facilitator, drawing upon discourses of differing degrees of power, which impacted upon the availability of client positions of agency and expertise in relation to alcohol. There was also a diversity of function within categories of client and practitioner speech. These findings have implications for clinical practice, in terms of moving beyond the recognition of ‘types of client talk’ and responding with an ‘MI consistent’ verbal behaviour, and moving towards reinvigorating the spirit of MI in relation to clinical outcome.
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